Osteoarthritis (OA) is the breakdown of the joint articular cartilage. This results in the release of matrix components and their degradation products into the synovial fluid where they may become exposed to the immune system and lead in some instances to an autoimmune response by the patient (Bannerji et al, Journal of Rhuematology 33:36.39, (1992); Poole, Osteoarthritis, W. B., Saunders, pp 155-189 (1992)). Disease activity in OA patient and their response to drug treatments have been monitored using clinical and radiologic methods of assessment (Theiler et al, Osteoarthritis cartilage, 3:1757-1774 (1994)). More recently however biochemical assays, which quantified PG epitopes ad matrix proteins in joint synovial fluid has been employed to follow disease progression (Setnikar, International Journal of Tissue Reaction, 14:253-261 (1992)). Although these biochemical markers have afforded important data on the turnover of cartilage and bone in OA joints, they cannot provide information on the cellular events that may be responsible for the abnormal metabolism of these tissues. Further more therapeutic agents whose mechanism of action may include effects on leukocyte populations are not readily amenable to study using these biochemical markers.
A large number of nonsteroidal anti-inflammatory drugs are currently used for the treatment of OA as first-line therapy; however several adverse effects limit their clinical usefulness. NSAID's do not slow the damage to the joints or change the course of the disease (Setnikar, International Journal of Tissue Reaction, 14:253-261 (1992)). Despite the ability of these drugs to improve the symptoms of the disease, their capacity to positively influence the progression of OA has been questioned (Anderson et al., Current Therapeutic Research, 58:93-107 (1997)). Moreover the deleterious effects of some NSAIDs on gastric mucosa and other organs have been of concern particularly during chronic usage of these drugs that is normally a prerequiste of the OA patient. Alternatively drug treatments have included intr-articular injections of hyaloroan or superoxide dismutase or daily oral administration of glucosamine sulphate al of which have been reported to provide symptomatic relief in OA patients. However the ability of these drugs to improve the underlying pathological causes of OA in patients or animal models has not been clearly demonstrated.
Hence there is an urgent need for a candidate preferably from the herbal source used in the traditional system of medicine with beneficial effects with minimum side effects. Plant based drugs have reported to exhibit minimum side effects and believed to be safe and are in use for thousands of years in the traditional system of medicine.